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Article
Iron Deficiency Anemia: The Utility of Upper GastrointestinalEndoscopy and Histopathology

Authors: Ali M Al-Doori PhDHematol --- Yaseen H Al-Dulaimi --- Adnan MH Al-Hamwandi
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2007 Volume: 4 Issue: 1 Pages: 43-46
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: occult blood loss must be considered as a possible cause in every case of iron deficiency anemia.
Objective: to evaluate upper gastrointestinal endoscopy in finding a potential cause for iron deficiency anemia among children in Al-Anbar governorate.
Methods: Twenty five children aged 2-14 years, referred to the gastroenterology unit in Al-Ramadi General Hospital for upper gastrointestinal endoscopy had iron deficiency anemia. Fiberoptic endoscopy was used under general anesthesia and endoscopic tissue biopsies were taken from 22 patients for histopathological examination.
Results: The main presenting signs and symptoms were pallor, abdominal pain, and stunting. The upper gastrointestinal endoscopy showed thinning of duodenal folds & serrated mucosa in 8 (32%), duodenal ulcer in 3 (12%), esophageal varices in 1 (4%), nodular gastritis in 1 (4%), and reflux esophagitis in1 (4%), with a yield rate of 56%.
While tissue biopsies revealed histopathological findings suggestive of celiac disease in 12 (48%), Giardia lamblia in 2 (8%), Helicobacter pylori gastritis in 1 (4%), and esophagitis in 1 (4%). There was a significant association between the endoscopic finding of thinning of duodenal folds and serrated mucosa and the histopathological finding suggestive of celiac disease, P<0.05.
Conclusion: Iron deficiency anemia in children 2-14 years of age warrants upper gastrointestinal endoscopy to find potentially treatable causes for the iron deficiency anemia.
Key words: Children; Iron deficiency anemia; Upper gastrointestinal Endoscopy.


Article
Experience Of Gastric Cancer In Al- Sadder City in Baghdad

Author: Maytham Hatam Shahid, Saad Ramadan Jawad, Asaad Abdullah Abbas
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 2 Pages: 129-137
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: The aim of the study is to assess the following points among the patients with gastric cancer admitted to the surgical wards in Imam Ali Hospital- Al- Sadder City- Baghdad.•Sex and age distribution. •Mode of presentation.•Results of endoscopic findings and histopathology.•Risk factors and tumour staging.•Treatment options.PATIENTS AND METHODS:A prospective study was done in Imam Ali Hospital for a period of six years from (January 2009 to December 2014) where fifty cases with biopsy proved gastric cancer had been assessed. The age and sex distribution, mode of presentation, site of the tumour, macrosopical appearances histopathological findings, risk factors and treatment options were analysed.RESULTS: The male to Female ratio was 1.4:1, peak age incidence was 60-70 years, non-specific symptoms such as vague epigastric pain, dyspepsia, anorexia, weight loss were the most common symptoms; esophagogastric junction was the commonest site, polypoid type was the commonest endoscopic finding (44%); upper gastrointestinal endoscopy with biopsy was the most accurate method of diagnosing gastric cancer; Adencarcinoma was the most frequent histopathological type (96%); cigarette smoking is the predominant risk factor (64%) (32, 33, 34, 35); In the majority of those patients the disease was advanced and the curative measures were not possible.CONCLUSION: Gastric cancer remains a significant problem in Iraq, it's one of the most popular malignancies (ninth most common in Iraq) (37). No age group of both sexes can be excluded. Late presentation is a stigmata of the disease and the gloomy prognosis can only be improved by early detection based on a more vigorous diagnostic approach following a high risk index of suspicion in individuals at risk.


Article
Effectiveness of the Instructional Program on Physical and Psychological Status of Patients Undergoing Upper Gastrointestinal Endoscopy at Baghdad Teaching Hospitals
فاعلية البرنامج التعليمي على الحالة الجسمية والنفسية للمرضى الخاضعين للتنظير المعدي المعوي العلوي في مستشفيات بغداد التعليمية

Authors: Ammar Kadhum Gaeed --- Khalida Alwan Mansour
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2015 Volume: 5 Issue: 1 Pages: 166-174
Publisher: University of Kufa جامعة الكوفة

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Abstract

Objective: The present study aims to investigate the effectiveness of instructional program on the physical and psychological status of patients undergoing upper gastrointestinal endoscopy. Methodology: A quasi-experimental study was conducted in the outpatients and medical unite for the Gastroenterology and Hepatology unit in Baghdad teaching hospital and Al-Kindy teaching hospital Imamein Kadhimein Medical City for the period from the 5th of January 2014 to 17th August 2014. A non-probability sample was selected and composed of 100 patients divided into (50 patients within the study group who received the instructional program about upper gastrointestinal endoscopy and 50 patients within the control group were not exposed to the instructional program The instructional program was developed by the researcher and consisted of the information domain and trained domain and giving at least 7 day before the endoscopy procedure. A questionnaire was prepared for evaluating of patient physical status (through measuring the intensity of pain during the procedure by visual analogue scale and patient discomfort by (retching, attempt grabs the endoscope, body movement and moaning) and measuring the pulse rate and oxygen saturation blood pressure) during the procedure. While evaluating the psychological status (through measuring (state and trait anxiety) before and after the procedure. Identified validity of the questionnaire and instructional program by a panel of 28 experts, and identified the reliability of the search tool by adoption of a pilot study. Data were analyzed using descriptive statistics and inferential statistics.Results: The results of the study in regards of physical status (measurement of the pain intensity) there is a high significant difference between the study group and the control group, while the measurement of the discomfort also a highly statistically significant were founded between the study and the control group related retching, attempt grab the endoscopy, the movement of the patient's body and moaning except retching were no statistical observed. In addition the study revealed statistically significant between the study and control groups when measuring the pulse rate and oxygen saturation except measuring blood pressure As for the psychological status (anxiety state) There are no significant differences between the study and the control groups during the pre-test, but there are highly statistically significant between the each group during the post-test, while ( anxiety trait) no statistical significance between the each group during the pretest, post-test.Conclusion: The study concluded that there is a positive effect of instructional program implementing on physical and psychological status of patients undergoing upper gastrointestinal endoscopy in Baghdad teaching hospitals.Recommendations: The study recommended to circulate the pamphlet that prepared by the researcher for upper gastrointestinal endoscopy units in Baghdad teaching hospitals affiliated to the Ministry of Health, which serves as a guide for patients to comply with all instructions to reduce patient discomfort during endoscopy procedure and also reduce anxiety.

الهدف: تهدف الدراسة إلى إيجاد أثر البرنامج التعليمي على الحالة الجسمية والنفسية للمرضى الخاضعين للتنظير المعدي المعوي العلوي في مستشفيات بغداد التعليمية.المنهجية: أجريت دراسة شبه تجريبية في وحدات تنظير الجهاز الهضمي في مستشفى بغداد التعليمي ومستشفى الكندي التعليمي ومدينة الإمامين الكاظمين (ع) الطبية, وللمدة من الخامس من كانون الثاني 2014 ولغاية 17 آب 2014 . اختيرت عينة غرضيه غير احتمالية متكونة من 100 مريض مقسمين على أساس ( 50 مريض ضمن مجموعة الدراسة الذين تلقوا برنامج إرشادات حول تنظير الجهاز الهضمي العلوي و50 مريض ضمن المجموعة الضابطة لم يتعرضوا لبرنامج الاشادي, تم بناء البرنامج التعليمي من قبل الباحث. تم إرشاد وتدريب المريض من قبل 7 أيام وكذلك تزويد المريض بكتيب يتضمن من محورين هما المحورالمعلوماتي والمحور التدريبي ولتقيم اثرالبرنامج على الحالة الجسمية تم قياس شدة الألم من خلال المقياس البصري التماثلي بالإضافة إلى قياس عدد مرات التهوع ومحاولة مسك جهاز التنظير وحركة الجسم والأنين خلال التنظير وقياس معدل وضغط الدم النبض وتشبع الأوكسجين بالدم) وتم جمع المعلومات بطريقة الملاحظة المباشرة للمريض في وحدات تنظير الجهاز الهضمي أما تقيم اثر البرنامج على حالة المريض النفسية من خلال قياس قلق المريض (حالة وسمة) قبل وبعد النتظير وتم ملئ الاستبيان من قبل المريض. وحددت مصداقية الاستمارة الاستبيانية من خلال (28) خبيرا, وحددت ثبات أداة البحث باعتماد الدراسة المصغرة., تم تحليل البيانات باستخدام أساليب الإحصاء الوصفي والإحصاء الاستدلالي .النتائج: أظهرت نتائج الدراسة بوجود فروق ذات دلالة معنویة عالیة بمقياس شدة الألم بين مجموعة الدراسة والمجموعة الضابطة بما يخص قياس عدد مرات التهوع و محاولة مسك جهاز التنظير, وحركة جسم المريض والأنين, النتائج بينت فروقات ذات دلالة إحصائية عالية باستثناء التهوع. أما معدل النبض وضغط الدم و نسبة تشبع الأوكسجين بالدم بينت النتائج وجود دلالة إحصائية بين المجموعتي الدراسة والضابطة باستثناء قياس ضغط الدم .أما بخصوص الحالة النفسية (القلق كحالة) لاتوجد دلالة إحصائية بين المجموعتين من خلال الاختبار القبلي ولكن توجد دلالة إحصائية عالية بين المجموعتين من خلال الاختبار البعدي, اما (سمة القلق) توجد دلالة إحصائية بين المجموعتين من خلال الاختبار القبلي ولكن لاتوجد دلالة إحصائية بين المجموعتين من خلال الاختبار البعدي . الاستنتاج : أستنتجت الدراسة بأن هنالك تأثير ايجابي للبرنامج التعليمي المنفذ على المرضى من الناحية الجسمية والنفسية للمرضى الخاضعين للتنظير المعدي المعوي العلوي في مستشفيات بغداد التعليمية .التوصيات : أوصت الدراسة بتعميم الكتيب المعد من قبل الباحث على وحدات التنظير الهضمي العلوي في مستشفيات بغداد التعليمية والتابعة لوزارة الصحة، والذي يعد كدليل للمرضى للامتثال لجميع التعليمات وذلك للتقليل من الآثار الجسمية والنفسية أثناء إجراء التنظير.

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